An endovascular procedure is a surgical procedure in which a catheter or other interventional device containing medications or miniature instruments is inserted percutaneously into a blood vessel for the treatment of a vascular disease or condition. Examples of endovascular procedures may include the insertion of a catheter in an occluded or narrowed vessel so as to open the occlusion with a balloon, position a stent, position a pressure monitoring lead, stabilize a vascular aneurysm, or any other number of indications. In general, a guidewire is used to support advancement of a catheter or other interventional device in a target vessel to be treated, and the devices may be positioned in the desired location under fluoroscopy.
For example, a catheter may be introduced over a guidewire and appropriately positioned in a patient's occluded vessel with a relatively stiff guidewire to cross the occlusion and provide sufficient rigidity and support to the catheter. A balloon catheter may then be introduced over the guidewire and the balloon inflated to open the lesion and/or to place a stent at the site of the lesion.
In many instances lesions or stenosis are present at a bifurcation in a patient's vessel, thereby requiring separate catheters and guidewires to be inserted into branches of the bifurcation, necessitating the introduction of multiple catheters and guidewires. Furthermore, a physician may want to introduce multiple interventional devices to the vessel, or desires to introduce drugs to a particular vascular situs, requiring more than one guidewire to be inserted and left in place so that another catheter or device can be employed. Unfortunately, when multiple guidewires are employed, the guidewires can become crossed or entangled within a vessel. In addition, the introduction of multiple guide wires is time consuming and compounds the attendant risks to the patient associated with any catheterization procedure.
Thus, there exists a need for a system that provides for the quick, safe, and efficient deployment of multiple guidewires simultaneously so that multiple catheter-borne interventional devices may be introduced, interchangeably, over any one of the indwelling guidewires. Furthermore, it is advantageous to have a system that allows for the placement of multiple parallel guidewires while avoiding entanglement or entwining of the guidewires.